Objective: This systematic review aimed to identify the referral criteria for palliative care in patients with Parkinson's disease.
Methods: We conducted an electronic search for publications on referral criteria for palliative care in patients with Parkinson's disease in six electronic databases. The articles were thoroughly reviewed by two independent reviewers for inclusion using a predefined data extraction list. The referral criteria were thematically classified using a coding methodology.
Results: This systematic review included 36 publications. We identified 14 referral criteria themes. The most common referral indicators were functional decline (n = 11 [31%]), needs assessment tools (n = 11 [31%]), physical or emotional symptoms (n = 10[28%]), need for palliative care (n = 10 [28%]), decision support (n = 9 [25%]), advanced Parkinson's disease (n = 7[19%]), and diagnosis of Parkinson's disease (n = 7 [19%]). However, there was a lack of consensus on symptom assessment tools. In addition, there were no agreed cut-offs or defined time for palliative care referral for patients with Parkinson's disease.
Conclusions: The 14 themes identified in this systematic review were categorized into disease- and needs-based criteria. These themes show the wide range of referral timing and procedures. Further studies should be conducted to reveal standardized referral criteria.
Keywords: Palliative care; parkinson’s disease; referral and consultation; selection criteria; systematic review.
Despite evidence showing the benefits of palliative care in patients with Parkinson’s disease, there is a lack of consensus on when, how, and why patients with Parkinson’s disease should be referred for palliative care. This manuscript summarizes and evaluates the criteria taken into account when making a palliative care referral for patients with Parkinson’s disease. We identified 925 publications. However, only 36 publications were included in the final analysis. Furthermore, we identified 14 themes that were categorized into disease- and needs-based criteria. This systematic review emphasizes the wide range of referral timing and procedures. Moreover, there is a need for more research to reveal standardized referral criteria.